Very bizarre afternoon and feel out of sorts

@FollowingSeas read my post again, and my post above. Of course I'm not conflating the two, in fact I made a point to state the opposite.

I think the problem is that people see this kind of individual as either 'mad' or 'bad'. If people can't prove he has a diagnosable mental health condition, then they assume he's just 'bad'.

Personally, I believe anyone who would do this, is in need of support. They may or may not have a diagnosed mental health condition. But their behaviour is a reaction to something - likely past trauma. To those who say "he may be getting a kick out of it - he's just a wrongun" - well in that case he needs support to understand why he would want to get his kicks that way, what is his life missing? What trauma has he experienced to make him behave this way for kicks?

It's hardly the life a child dreams of is it? What's gone wrong for this guy and how can we help him so he doesn't keep repeating these behaviours?

If he's aggressive with the paramedics - then we need to understand why otherwise he will.keep.doing it. If it's because they call him a faker and a time waster, then I suppose we can see why he might be aggressive with them. If they are perfectly pleasant with him, then it's about something else - maybe a bad experience with health care.profeasionals.as a child.or.something. The reasons need to.be established so intervention can be put in place.

We cannot as a society just ignore and criminalise someone like this. It won't work to stop the behaviour - he has a court order and is.still.doing it after all! He really needs.psychological evaluation in my opinion, and then a supportive intervention to address his issues and help him find more appropriate ways of getting his needs met. He sounds lonely and miserable :(

All people saying how sad this is and how he must have unmet needs - do you feel this way about other criminals?

This person is a fraud and is deliberately acting in a way to take away scare resources from those who need them.

Maybe keep your sympathy for the old lady with a broken hip who waited longer for an emergency ambulance because of him or the parents of a child with their first febrile seizure who were terrified whilst waiting for an ambulance.

I said to DH that whatever his needs are - they aren’t being met. I don’t know the answer or why. Or what society can do. But I feel very out of sorts

You did what you felt was right at the time and that was all you could do.

Let's face it, what you experienced was clearly a very unique situation with someone having extremely complex MH needs. No societal system out there can ever be set up and funded to meet the needs of that person. That's life.

I'm sorry, but I'm not clear from your post whether you are conflating psychogenic seizures with faking seizures? Which really isn't correct. It is also not uncommon to have both epileptic and psychogenic seizures.

My DS has epilepsy and we happen across medical professionals who come out with this shite. It's harmful and not all epileptic seizures are typical. My biggest fear around his epilepsy (apart from SUDEP) is the treatment he may recieve if he ends up in A&E after we had one bad experience.
PNES are also not fake seizures, the sufferer has no control over them and its not a diagnosis you want as medical professionals can be awful. The man in the OP's just sprang back to life when questioned, this is not PNES.
A friend's daughter had her epilepsy drugs removed as her seizures didn't look "typical", she ended up very poorly after a massive epileptic seizure. There are reports of people dying after being not believed (typically young women).

Indeed, but if someone started a thread feeling upset because they’d been burgled and their bed had been urinated on and their stairs defecated on (these things I know have happened in a burglary), everyone on the thread would rally around them and condemn the antisocial, immoral activity. If anyone posted in response “They are clearly unwell and answering some need in themselves”, the poster would be given very short shrift. You could argue that any antisocial and/or law-breaking activity has mental causes.

Many of these behaviours would have underlying mental causes.

I’m by no means an expert in mental health but have known a few cases like this and the term they used was that it wasn’t mh related but “behavioural” as in the person had spent significant time being assessed by mh professionals and wasn’t diagnosed with relevant conditions, had capacity and had support and coping strategies put in place and they were still carrying out the actions and had wasted considerable time and resources already hence the order being granted. You have to evidence the impact the person has had on services to get one. Obviously the person is getting something from it and it’s probably to do with enjoying feeling cared for for that period of time but a better solution is needed as front line staff are often tied up inappropriately. It’s one for the right care, right person approach.

To add, an epileptic or neurological seizure presents very differently to a psychogenic seizure, although to a lay person with no medical background they may appear the same. This man was faking an epileptic seizure. Someone having a psychogenic seizure would present differently and this would have been very clear to the paramedics.

It seems that some people want to believe “this man is mentally ill and needs help”. It is a more comforting thought, than the idea that he has a kind of addiction to being antisocial, and is more akin to people who feel compelled to commit burglary, exhibitionism, voyeurism, stalking, attacking strangers… He enjoys duping and controlling people, violating boundaries for goodness’ sake. If people perpetrate burglaries every night, or hide in bushes to hiss obscenities at teenaged girls while masturbating, people don’t say “They are clearly mentally ill and need help”, they say these people need to be stopped and the public needs protecting.

Agreed.

It's great that so many people on this thread are empathetic, lovely people who would feel sorry for this man and assume he must desperately need help in some other way, but unfortunately having worked as a paramedic for over a decade there are absolutely people out there who just have bad intentions.

Getting to the point of a court order banning him from calling ambulances is HUGE. This just does not happen, even to our most regular regulars. This will have been explored by multi-disciplinary teams including mental health teams to see what can be done to mitigate the high volume of calls way before getting to the stage of a court order.

There are plenty of people who very sadly suffer from psychogenic non-epileptic seizures, and these people of course absolutely do need help, care and support, albeit often mental health care rather than physical. Their symptoms are very real and frightening to them and these people are just not labelled 'fakers' like some on here have suggested.

There are also people who deliberately fake symptoms of a seizure (+/- other symptoms) and have made a conscious choice to dupe those who come to their aid as well as healthcare/medical professionals for some kind of perverse kick. I've known some patients like this to repeatedly expose themselves during these 'episodes' or put themselves in a position where they are pressed up against nurses etc. As unpalatable as it may be, we need to accept that these people exist. It sounds like the man you met in this scenario was unfortunately one of these, OP. You still did exactly the right thing going to his aid as of course you weren't to know this, and as a professional I would do the same without any knowledge of his history.

I used to work in a large high street shop. We would used to have a woman who would come in and fake collapsing. We knew her, we knew she was faking but we couldn’t not call for an ambulance. It might have been real. We would look after her and shoppers would be worried, want to help etc but it’s really hard to say to people to ignore her because she’s faking it.

Please ignore this if you come across someone having a seizure in public. I am trained on what a nonepileptic seizure and a fake may look like compared to the presentations of typical epileptic seizures and would always treat as real first unless I had very good reason.

Call an ambulance and let them decide. Unless you are in such a role where this is a distinction you are trained to make, performing tests to check whether an emergency situation is real is so inappropriate.

You did the right thing. The saliva will wash out. No lasting harm and you could have saved a life. I have epilepsy and there have been times nobody has helped me, police officers have accused me of being a drug addict, a sex worker and many people have walked past or made stupid comments. One man took the opportunity to start touching me inappropriately after a seizure. Please don't stop doing the right thing and caring about others. I appreciate it

Paramedics do amazing work in emergency medicine but they aren't psychiatrists. They can't say for certain he doesn't have MH issues and it sounds very much like he does if he is committing arson. These could be nonepileptic seizures (psychogenic).

Just because he doesn't have a MH diagnosis at current doesn't mean he doesn't have something complex behind his behaviour. Healthy people don't usually fake seizures for attention or start fires.

Those are for prisoners faking seizures. If you come across someone in the street having a seizure, you look after them. Very occasionally, you’ll get an idiot attention-seeker, like this chap, but the majority of the time not. OP did the right thing.

Please look after people with epilepsy if you come across them in the street or in a shop

https://www.epilepsy.org.uk/when-someone-has-a-seizure-care

Does he suffer from Munchasens, (I think it has a new name now), which is when you fake illness to get attention?

Even though it wasn’t genuine, you did the right thing, and supported a person (apparently) in need.

@Iwashopingnottobreakmyduck That was a horrible thing to have happen, especially as this horrible faker dribbled all over your daughter's coat.

Here is a guide to epilepsy fakers by a professional who works with people likely to do this.

{Online}

(1) The Electric Shock Boogaloo. If he is shaking like he is getting a short-circuited washing machine mind-meld - it's pretty much a guaranteed fake. (Just had one of these last week.)

(2) “Collapsed” into a suspiciously comfortable position. Particularly suspicious if he somehow managed to fall with his head landing on the pillow that happened to be on the floor. (Yes, I've seen this.)

(3) If you drop his hand on his face, but it misses and falls to one side or the other. Not as “unconscious “ as he is pretending.

(4) A vigorous Sternum Rub seems to work some absolute miracles in reviving certain “seizure victims “.

The 'Sternum rub' is where one makes a fist, and rubs the knuckles up and down the breast bone in a scrubbing motion- It is very uncomfortable.

People like this piss me off. What makes people do shit like this?😡😡😡

My son and daughter both suffer with epilepsy. DS suffers the worse been fighting for his life a few times.

Nope, he may not be able to control them if it’s PNES that is the cause. Must have been convincing if an A&E doctor was taken in. Besides which, even if he’s not mentally ill with anything clear cut and diagnosable, Firstly, MH issues are notoriously difficult to diagnose because there can be huge symptom crossover etc, and secondly, nobody behaves that way simply because they’re a knob. Behaviour is communication. No completely psychologically sound, happy and contented person behaves in this way.

My first thought was this https://my.clevelandclinic.org/health/diseases/24517-psychogenic-nonepileptic-seizure-pnes

He clearly is very psychologically distressed.

*knobs

Yes, perhaps.

But why should that trump someone else's genuine need for ambulance care?

Mental health or not, this bloke wasn't experiencing an emergency and I bet he knows full well the impact his actions are having.

Sometimes I think humans are far too quick to assign 'mentally ill' as an excuse for shitty behaviour because it's more palatable than admitting that some human beings are just knows.

@Jimmyneutronsforehead it sounds like he was attended by paramedics, who assessed him at the scene, so he would always have support.

I agree that the thornier issue here is that this gentleman needs to be supported to receive what he needs without having to resort to duping people into thinking he has a genuine medical emergency.

What happens if he genuinely needs medical assistance if he's court ordered to never use an ambulance?

Isn't that basically condemning someone to death? It doesn't sound like he's the kind of person to have support to get to hospital if he does need it. Mostly because he's a massive time and resource waster, but what happens in a genuine situation?